changing ins. right before my operation.......HELP!!

FlourPower
on 2/10/08 11:35 am - PA
This is what's going on and I can't believe it!!  My hubby came home the other night and told me that his company that he works for is thinking about changing their insurance company.   I went into my Dr's office and asked them about my surgery date.  I was really hoping that I was going to get in the month but I'm not sure that I will.  The doctor is booked up for Feb. and the only way that I'll be able to get in the month is is someone has to cancel their operation.  They told me that I'll probably be looking at a early March to mid March date for my operation.   Now I have to remember that my hubbies work on "only looking" but still they could switch as early as the beginning of March!!! YUCK!!! They are looking at Geisinger and I don't know a thing about them.  I know that they told DH that they would not take a plan that has a WLS exclusion.  I am glad about that.  And they have "hinted" around that they might even wait until after my surgery which would be AWSOME!!!   Does anyone have any advice about my situation????   I would greatly appreciate any and all help!!  Thanks I also wanted to add.  I don't know if Geisinger would just let me have the surgery OR if they will make me go through another six month diet...EKG....EDG.....Chest X-ray.....Psych Eval......etc......I really don't want to have to do all of that again.   Does anyone know???? Thanks!!   Chrissy
FlourPower
on 2/11/08 7:13 am - PA
does anyone have any experience with this one????
bonnied
on 2/11/08 10:11 am - St. Albans, VT
First of all....take a deep breath......I know how hard you have worked for this and it is not going to disappear.......believe me! I am not familiar with your insurance but I will tell you a few pointers. All the info can be used with another insurer. You will not have to get more tests like an EKG, just provide them with the records. Why would they want to pay for it if the other insurer already had? The only exception I can see is possibly the psych eval. Some insurers and specific policies within require certiain psych testing (BCBS is one) that not all insurers require. You could possibly have to have more in-depth psych screening--big whoop---no problems, and they'll pay for it if it's needed anyway. Also any medically supervised diet records, etc will carry over. All you need to do is find out the specific criteria and provide it for them. Is there a website for the new insurer you can check out? If you type in bariatric surgey in the search box you can often get to the medical policy and criteria. One word of caution though---each company can have changes made to their specific health insurance policy, so the info you find on the web might not be exact to your specific plan, but will be a good start. You will not be able to get exact specifics unless you have a 1-800 number to call and a ID number to give them. Good luck! Bonnie 264/154 lap rny 6/3/5
FlourPower
on 2/12/08 1:44 am - PA
Thanks Bonnie for your help. I did call the 1-800 number yesterday for Geisinger and the lady was very helpful.  I explained to her that we do not have Geisinger as of yet but that my hubbies company is thinking of enrolling.   I then told her about my delima.  Today she got back to me and told me that she went to the Medical Supervisors (she said they are in charge of approving WLS) and they told her that I will have to start over again.  They will want a new six month diet etc....from what she said I'll have to do all of this over again.  I really don't want to have to do it again.  It seems silly....I just had all of this done.  It's not like the tests are going to have different results.  I could understand if they wanted to me have a test that I have not had yet...but that doesn't seem to be the case.   Thursday is the day that Geisinger is supose to come to my hubbies work.  I'll know more then. I jsut hate the fact that this is happening! Thanks again, Chrissy
smidgen21
on 2/14/08 9:27 am - Central, MI
TRaphael
on 2/28/08 12:48 am - East Brunswick, NJ
We changed insurance a week before my surgeon was ready to submit my claim in. It was no big deal. As soon as I got my new insurance card, they submitted all of the information to the new insurance company and I was approved within a week. Turns out my new insurance company was easier to get approval than the original insurance company. I did not have to redo any of the tests. All the documentation is fine. The only thing that matters is what your new insurance requires.
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